| NPI | 1336175215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NY 221305-1) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D0082346) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ME MD18504) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD057975L) | |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2023-08-21 |